Nuances of jawline and chin augmentation in men better understood — with more routes to achieve contourNuances of jawline and chin augmentation in men better understood — with more routes to achieve contour

Few facial features are more associated with masculinity than the classically strong or squared jawline. For male cosmetic patients, that "Brad Pitt" signature look is ever more attainable as cosmetic surgeons better understand the subtle nuances that comprise the male jawline and learn to work with next-generation implants and fillers to provide optimum contour.

BEYOND MERE BULGE Whereas the chin implants of the past typically gave the appearance of little more than a bulge right at the front of the chin, the newer generation of implants now pay greater respect to the entire jawline and areas such as the prejowl sulcus. "Most surgeons currently use chin implants with a tapering tail that wraps around the mandible in a contiguous line, rather than giving a big chin and a smaller jawline," explains Anthony P. Sclafani, M.D., director of Facial Plastic Surgery at The New York Eye & Ear Infirmary in New York, N.Y., and professor of Otolaryngology at New York Medical College, Valhalla, N.Y.

"But there's more attention being paid specifically to the prejowl sulcus, and you can get implants that help with that point and push that depression up." Experts tell Cosmetic Surgery Times that today's implants, which are designed for specific anatomic zones, have allowed surgeons to better address the many facets of the male facial bone structure while maintaining a look that keeps a natural balance with the contours of the face.

Last-generation implants, for instance, only took into consideration the specific area between the mental foramina, or the central mentum zone, according to Edward O. Terino, M.D., a facial plastic surgeon who is director of the Plastic Surgery Institute of Southern California, in Thousand Oaks, Calif.
In a recent paper, Dr. Terino explains that more focus is now given to other anatomical zones, including the midlateral zone of the premandible space, extending from the mental foramen to the oblique line of the horizontal ramus of the mandible.

"Augmentation of this zone, in addition to the central mentum, produces widening of the anterior jawline, which appears anatomically natural," Dr. Terino notes. Additional attention is also being paid to the posterolateral zone of the premandible space, which includes the posterior half of the horizontal ramus and the angle of the mandible and ascending ramus. "Implants can variably augment this zone to produce a strong posterior jawline contour with sculptured definition," he says. Newer implants can also address another section of the premandible space — the submandibular zone — by wrapping around the bony inferior margin of the mandible and increasing the vertical distance from the lower lip to the inferior chin line. "This augments the submandibular zone to increase the mass of the lower third chin jawline facial aesthetic segment," says Dr. Terino.